The present study was conducted to investigate the recognition and experience of adverse events by patients and/or their families at dental clinics. A self-administered questionnaire mail survey was conducted in 2,000 subjects (response rate, 29.0%). The responses included descriptions of 19 experiences of adverse events at dentists, and one of these subjects was interviewed. In regard to the recognition of adverse events at dental clinics, the patient and his/her family first recognized unusual pain, a decline in oral function, or other unusual changes, and then recognized and judged adverse events according to the information provided by medical professionals, such as discrepancy between the diagnosis/treatment and treatment outcomes. In addition, inappropriate communication by medical professionals had some influence on the recognition of adverse events. Medical professionals are required to interview patients regarding their past treatments and outcomes, and the treatments and outcomes they want, and then are required to provide patients with sufficient explanation about potentially negative treatment outcomes and symptoms.

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Evaluation of the quality of medical care, involving comparison among multiple medical facilities, is possible, if a clear definition is provided for each clinical indicator and the data extraction method is standardized. In Japan, an attempt to conduct this kind of evaluation utilizing Diagnosis Procedure Combination (DPC) data as common data for acute care hospitals has been started. The National Hospital Organization has made public the logic behind such an attempt. The present study was undertaken to evaluate the quality of medical care at acute care hospitals, including analysis in relation to the hospital scale (number of beds), with the use of clinical indicators prepared by the National Hospital Organization. The results of this study indicated the necessity of evidence- and guideline-based standardization of the timing to start early rehabilitation, and to end prophylactic use of antimicrobial agents at hospitals covered or planned to be covered by the DPC data scheme which participated in our study. It would also be desirable to analyze the association between the number of patients and the status of each clinical indicator.

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